I have a dental provider that I code for who will code 2 restorations on the same tooth, same day, different surfaces, sometimes with the same material & sometimes not. I have requested that if they are of the same material, that she use 1 code with a larger # of surfaces. Are there any situations where it would be correct to code 2 restorations of the same material on 1 tooth?

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  • I have a dental provider that I code for who will code 2 restorations on the same tooth, same day, different surfaces, sometimes with the same material & sometimes not. I have requested that if they are of the same material, that she use 1 code with a larger # of surfaces. Are there any situations where it would be correct to code 2 restorations of the same material on 1 tooth?

I have a dental provider that I code for who will code 2 restorations on the same tooth, same day, different surfaces, sometimes with the same material & sometimes not. I have requested that if they are of the same material, that she use 1 code with a larger # of surfaces. Are there any situations where it would be correct to code 2 restorations of the same material on 1 tooth?

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Asked on March 21, 2012
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It is inappropriate and fraudulent to code two separate fillings on the same tooth when a more appropriate code exists. This kind of billing is called unbundling and is considered fraudulent and abusive.
Rule of thumb: always code to the highest level of specificity, meaning if a more appropriate code exists use the more appropriate code at all times.

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Answered on March 22, 2012
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